Jun 25, 2019 in Health

Self-Care Deficit Theory

Nursing theories provide helpful insights that enable nurses deliver services that are patient-centered. They provide clarity on what is expected from a nurse in terms of the scope, meeting patient needs and the goal at hand. Over and above, it’s the nursing theories that provide a reference platform helping the nursing discipline provide a therapeutic and caring environment that is helpful in patients’ recovery. The objective of this paper is to provide an in-depth analysis of Self-Deficit Theory and its applicability in case manager undertakings.


Self-Deficit Theory

Author’s Name, Background and Motivation

Self-Care Deficit Theory is a grand nursing theory that was formulated by Dorothea Orem, a BSN holder, in 1939 and later attained a master degree in nursing in 1945 (The University of Tennessee, 2014). Later Orem worked in the office of education ‘Department of Health Education and Welfare’ (HEW) where she played a role of a curriculum consultant. It is here that Orem found the need to have clarity in terms of the real engagement a nurse should facilitate. As a result, she started working on the ways to ensure that there was a curriculum upgrade that would contain practical nursing training. The theory came about as a result of Orem identifying the gap in the nursing curriculum. Another aspect that brought the necessity for her to formulate the theory was the continued exposure to nurses and their undertakings in the years 1949-1957 (The University of Tennessee, 2014). According to Orem, her intention behind the theory was to attain a clear understanding of the subject matter in nursing. To attain this, there was a need to have a curriculum that isolates and specifies the nursing action. This was a primary motivating factor behind Orem formulating the self-care deficit theory. 

Crucial References 

The primary reference consulted by Orem is the action theory. The action theory argues that actions are better understood from the interactions between the forces that are guiding the actions. In the same spirit, Orem utilized this perspective and formed the Philosophical view the patients wish for self-care (Parker & Smith, 2010). It is thus the aim of nursing to ensure that action of man’s self-care is attained. Based on this perspective Orem comes up with actions leading to an eventuality where personal limitations (patients’) are no longer a challenge. Nursing should be helpful up the point at which the patients are able to ‘self-care’ themselves. In the formulation of the theory, Orem also paid reference to the ‘World View’ perspective, where she utilized the ‘organicism’ aspect of it. She asserted that man interacts with the environment under a self-care system.

Problems Addressed by the Theory

The primary problem addressed by the theory was clarifying the subject matter of nursing. This was attained by Orem coming up with clear goals and the scope of nursing (Alligood, 2010). She agitated for accountability and action-based nursing curriculum that would help the nurses serve their patients better. 

Theory Description


The theory was based on an induction approach whereby what necessitated the theory was a keen analysis of the curriculum and that is what allowed her identify the need for clarity in terms of the subject matter of nursing. Besides, most of the concepts of the theory were based on a thorough analysis of nursing practices, built on nursing care materials (curriculum). Another aspect that motivated Orem into formulating the theory was her exposure to nursing undertakings in the years 1949-57 (The University of Tennessee, 2014). The system utilized was the induction type, where Orem was keen on identifying the variables at play in nursing via the curriculum that nurse students and the action of registered nurses. Through the analysis, she saw the need to upgrade the curriculum to enhance its practical aspect. There was an effort to theorize a pool of knowledge, which in consequently would help shape the curriculum for a diploma through specifying and isolating nursing action (Taylor & Renpenning, 2011). The utilization of the specific aspects of nursing leading to the formulation of an upgraded curriculum, is a clear indication of an inductive approach in the formulation of the Self-Care Deficit Theory.

Major Concepts of the Theory 

The primary assumption is that people are capable and willing to provide self-care, and nursing purpose entails the provision of the services that aid in the attainment of self-care (Alligood, 2010). Another concept of the theory is the fact that nursing is seen as a purposeful and deliberate service aimed at helping others over a specific period. It is also an assumption of the theory that people are able to provide self-care and, in addition, are capable of providing care for their dependable members. Self-care is also perceived as a necessity when it comes to human health and development. Human beings learn about self-care through communication and interaction. The self-care deficit is a result of the difference between self-care demands in comparison to self-care capabilities (The University of Tennessee, 2014).

Concept’s Definition, Relationship, And Consistency 

The concepts are defined explicitly with all them informing what nursing is about, the goals at hand and the parties involved. Besides, the concepts are clearly geared towards the attainment of a single goal of helping an individual attain self-care. There is no vagueness in terms of demands from the nursing process as a helpful component towards enabling people attain self-care. There is also a conspicuous consistency in terms of concepts’ utilization with the concepts aiming to achieve the sole aspiration of nursing, that of enhancing self-care. The concepts portray nursing as a facilitative discipline that helps individuals overcome their limitations, aiding in improving their health status that therefore helps them meet their self-care demands (The University of Tennessee, 2014). In addition, the concepts are theoretically defined based on the action theory, referenced by Orem. Moreover, the aspects of the theory are heavily interrelated by the mere fact that they prove that people are capable of providing self-care to themselves, and those not incapable of attaining self-care.



The theory of self-care deficit is based on two assumptions; one is that nursing is viewed as a discipline that helps in overcoming the human limitation. This strongly defines nursing goal as that of bridging the gap between the self-care demand and deficit. Another assumption is built on the fact that nursing concern revolves around the man’s need for self-care action (Parker & Smith, 2010). This assumption assists in defining where, how and when nursing actions are needed. These two presumptions were applied in formulating the scope and the purpose of the theory.

The theory has a detailed perspective on the four nursing metaparadigms namely, a person, nursing process, the environment, and health. Orem’s self-care deficit view of a person is that of a subject of nature. A person is influenced and affected by his/her surroundings and can engage in actions that yield development but above all can learn and attain self-care (McKenna, Pankhihar, & Murphy, 2014). Likewise, a person is a recipient of nursing services. The environment is defined as the space in which a man exists and which are heavily intertwined. The argument is that a human and an environment can never be separated. Besides, an environment is argued to be composed of biological, physical, social and chemical elements. The environment presents the greatest channel of impact on the person’s level of health. Nursing is viewed as the ability to provide assistance in terms of provision and designing of self-care. Orem vies nursing as an art, technology and a service to the community. It is a service to the community because of the interaction of the nurse with families. It is an art due to the component of designing and managing systems of self-care in the line of maintaining a certain level of human functionality (McKenna, Pankhihar, & Murphy, 2014). The technological aspect of nursing is present in its techniques employed in practicing. Lastly, health is defined as a progressive movement in terms of development towards an increased level of integrity and functionalism. It is viewed as a state of one being ‘wholly’ full of strength with no elements of diseases. It is the state of being on an optimal level in terms of one’s ability to undertake self-care.

Clarity of the Theory 

The theory demands are formed on the desire to identify when a person might be in need of nursing care. According to the theory, this is identified through determining whether there is any deviation from the self-care demands. The demand for therapeutic attention is based on the pinpointed level of one’s ability to meet his/her self-care demands (The University of Tennessee, 2014). This presents an example of how the theory is built on the matters self-care. The call is that nursing should concentrate on enabling a person meet the demand of being in a situation to provide the corresponding self-care. The theory demonstrates a comprehensive definition on all the four nursing metaparadigms, proving their importance when it comes to any nursing undertakings. The concepts ideas are absolutely compatible with the main goal of presenting nursing as a discipline that help people provide better self-care, which makes the theory understandable and to the point. Moreover, the theory is keen on teaching the nurses the goal of nursing through a precise definition of the scope and purpose of this process.

Having a clear understanding of the scope and subject of nursing was the Orem’s main target during the formulation of the theory. To this end, the theory outlines the four metaparadigms and provides a clear explanation of how they affect the person’s ability to practice self-care. Additionally, the theory provides insights on when and how nursing care is availed and under which circumstances. From the above illustration, the self-deficit theory is clear on the purpose of nursing. It is also successful in positioning nursing services as acting on a facilitative basis to help patients go back to the state of being self-sufficient in the provision of self-care.


General Applicability

The theory is keen on defining the scope and the purpose of nursing and bringing forth the primary goal of nursing. With the theory built on the basis of determining when a patient requires nursing help, it is simpler for the nurses to provide the much-needed help at the right time. In the same spirit, the self-deficit theory defines what a healthy person is able to achieve. According to the theory, unless a person is capable and willing to provide self-care, he/she requires nursing input to help him return to an ordinary state(Alligood, 2010). The theory demands a multi-discipline approach to nursing. It calls for the nursing to be carried out as an art, technology, and a service to the community. This is helpful in shaping the nursing process in a manner that is inclusive but at the same time thorough. The detailed analysis of the nursing metaparadigms permits the nurses to gain important insights on the phenomenon that helps a nurse appreciate the different variables involved in nursing. Furthermore, the theory brings forth a clear illustration of what nursing effort should be aiming to meet. Besides, it brings to the light the indicators to look out for in identifying when nursing actions are needed. These illustrations present the self-care deficit as a grand theory that clearly defines important indicators that help make nursing be a goal-specific discipline.

Practicing the Specific Applicability 

As a nurse case manager, the aim is to help in development, implementation, and evaluation of individually specific health care plans that are aimed at restoring and promotion of patient’s health. This is aimed at ensuring that the patient returns to a level of well-being that enables him/her be independent in terms of their health. The components that are of importance to the case at hand are the individualized health plan and independence. In the same manner, the self-care deficit theory agitates for the nursing services to help the patient return to the state of provision of aspects of self-care. Also, the theory emphasizes the need for assessment of the situation, which helps define the degree of therapeutic action required in restoring the health status of the patient. These are two paramount aspects of the theory and the duties of a nurse case manager. 

The theory provides insights on best practices to identify the level of the patient’s health status and corresponding appropriate nursing response. It calls for due diligent action in identifying the limiting aspect undermining the patient’s ability to provide self-care. As nurse case manager, there is the need to have an absolute clarity in the case at hand to help formulate a comprehensive care plan. The theory also requests clarity in terms of the nursing objectives. 

According to self-care deficit theory, clarity of the goal aids in ensuring that the nursing actions represent the relevant set of services required for assisting the patient in going back to being independent. In the same direction of thought, formulation of effective health care plans entails identifying and addressing all aspects of the patient’s health demands. Over and above, the theory explains that when a person is healthy, they can meet self-demands independently - a goal that is common for all nursing efforts.


Self-care deficit theory provides a knowledgeable platform, where a nurse case manager can grasp important concepts that can help the nurse approach her/his task in a more open-minded way, thus serving the patients better. The demand for clarity and specific medical plans is at the core of a nurse case manager mission, a phenomenon deeply rooted in the theory. Assessment is also agitated for by the theory, an undertaking that is also part and parcel of the obligations of a nurse case manager. These examples and the analysis above clearly positions the self-care deficit theory as an important reference to the undertakings of a nurse case manager.


Related essays